User:Peter morrell/boundary dispute

The term boundary dispute has several meanings but is especially found in sociology and in science.

In sociology, a dispute between two adjacent occupations, trades or professions in which some tasks are shared in certain work situations. Obvious examples include nurses, physicians and pharmacists in the tasks they can come share in patient care. Such disputes arise where the roles are blurred and ill-defined such that the tasks of one professional seem to overlap with the tasks allotted to a different but closely allied professional. Examples include who is permitted to undertake certain procedures (e.g. phlebotomy), make diagnostic decisions (e.g. mental illness), use specific pieces of equipment (e.g. syringe, sphygmomanometer) or issue certain drugs (e.g. barbiturates, morphine). Such 'blurring of boundaries' can lead to occupational friction, engendering discussion between members of allied professions and trades, about which specific tasks can or cannot be undertaken by which professional person. This in turn leads to sharper definitions of the roles of each profession.

Boundary disputes also involve the phenomenon of encroachment whereby adjacent domains seek to acquire power and control over aspects (tasks, knowledge) usually regarded as belonging to the other domain. Good examples include the process whereby radiographers, midwives and chiropodists, for example, achieved greater professional independence from medical practitioners early in the 1900s.

These disputes are usually resolved through negotiations between the professional bodies of the professions involved in the dispute. Examples include defining in what situations which professional is permitted to make a certain type of diagnosis or who can administer a certain drug or injection and who cannot. The resolution process involves making clear definitions of which tasks should or should not be allotted to which profession in the dispute.

In science, disputes arise about what truly belongs within the proper domain of science and what lies outside it, and can be labelled and dismissed as pseudoscience. This is a significant example of scientific imperialism, in which members of the elite class of scientists enter into dispute with intellectual domains adjacent to but beyond the recognised borders of their 'empire' in an attempt either to control, criticise diminish them or to annexe their territory and skills as part of their own. Such disputes are most often epistemological rather than about occupational tasks.

Boundary disputes also involve policing of boundaries to ensure that disputed knowledge is never allowed into the domain of science. This is related to peer review which ensures that only that knowledge which is approved by scientists is served up to scientists in their journals and text books. Disputed knowledge is expelled and denounced by 'border police' who constantly scour the boundaries of science to find and expel what are seen as illegitimate scientific claims and epistemological intruders. Border police therefore serve the function of preventing epistemological encroachment by dubious pseudosciences upon the hallowed domain of true science.

if philosophy and sociology of science should remain permeable to scientists, then scientists must also keep their borders open to philosophical and sociological investigation...Rather, it involves a concerted effort to disarm the institutional and intellectual borders that currently divide practitioners of the natural and human sciences.

''The demarcation of science from other intellectual activities-long an analytic problem for philosophers and sociologists-is here examined as a practical problem for scientists. Construction of a boundary between science and varieties of non-science is useful for scientists' pursuit of professional goals: acquisition of intellectual authority and career opportunities; denial of these resources to "pseudoscientists"; and protection of the autonomy of scientific research from political interference. "Boundary-work" describes an ideological style found in scientists' attempts to create a public image for science by contrasting it favorably to non-scientific intellectual or technical activities. Alternative sets of characteristics available for ideological attribution to science reflect ambivalences or strains within the institution: science can be made to look empirical or theoretical, pure or applied. However, selection of one or another description depends on which characteristics best achieve the demarcation in a way that justifies scientists' claims to authority or resources. Thus, "science" is no single thing: its boundaries are drawn and redrawn inflexible, historically changing and sometimes ambiguous ways.''

''Traditionally, surgeons (and to a lesser extent anaesthetists) have been assisted primarily by nurses. This role has been threatened in recent years, in the UK NHS (and elsewhere), by a relatively new profession, that of the Operating Department Practitioner (ODP). The ODP profession is still in the process of establishing itself as a 'full' profession within UK health care. While occupational boundary disputes between professions are common in health care, it is unusual for them to become as overt as the dispute we will analyse in this paper. Drawing on fieldwork observations and interviews conducted in operating theatres, as well as documentary sources, we will show how this dispute arose, how it is manifested at both the micro and the macro level, and how both groups involved justify their positions, drawing on surprisingly similar rhetorical strategies. A further unusual feature of this dispute is the fact that, unlike many attempts by managers to substitute one type of labour for another, issues of cost are relatively unimportant, as both theatre nurses and ODPs earn similar salaries.''

'...non-medically qualified dentists were excluded from holding teaching posts in the hospitals and universities...the dental profession remained open until 1921.' [11]

'The history of ophthalmic opticians in this century has been strongly influenced by sustained and vigorous opposition from the medical profession...the relationships between medical and ophthalmic occupations have been conflict-ridden.' [12]

'...a sense of medical proprietorship of X-rays developed very quickly. By 1903 complaints were appearing in the medical press about lay radiographers.' [13]

'...the BMJ [in 1905] noted that unsupervised lay use of X-rays was under attack from the medical profession in France.' [14]

'Despite the ancient origin of their skills, modern physiotherapists had to fight for a recognised place in the medical division of labour. Their terms of entry have chiefly been controlled by the medical profession...' [15]

'Doctors have in the past viewed chiropody as encroaching upon their own interests, which has led the BMA in particular to closely monitor and control its development.' [16]

'The Midwives Act of 1902 represented the culmination of decades of controversy...and represented a humiliating defeat for the BMA and GMC in that medical practitioners were not in a majority on the Midwives Board.' [17]

'Past legislation for Dentists [1921], Nurses [1911], and Midwives [1902] had all been delayed by medical hostility, and Chiropody proved to be no exception.' [18]

'[The Professions Supplementary to Medicine Act of 1960] provided for the registration of seven professions, viz. chiropodists, radiographers, physiotherapists, dieticians, occupational therapists, remedial gymnasts, and medical laboratory technicians...' [19]